====== CLINICAL CONTRIBUTIONS.======
{{anchor:s2}}BY R. R. GREGG, M.D., BUFFALO, N. Y.
{{anchor:s3}}I propose furnishing to the profession, through the columns of the Review, from time to time, reports of such cases, within my own practice, as may seem to involve valid illustrations of the law of Hahnemann.
{{anchor:s4}}I do not propose, in these reports, either theories or discussions, but simply a narrative of facts, and I shall, therefore, confine myself exclusively to cases in my own practice; and in these cases to the following points only:
{{anchor:s5}}1st. {{anchor:s6}}The condition and symptoms. 2d. {{anchor:s7}}The drugs administered. 3d. {{anchor:s8}}Their potency. 4th. {{anchor:s9}}The intervals of their administration. 5th. {{anchor:s10}}Duration of treatment. 6th. {{anchor:s11}}The result.
{{anchor:s12}}Case I. Acute Pneumonia, — A male child, eleven months old. {{anchor:s13}}He had been sick ten days under allopathic treatment, failing rapidly from the first. {{anchor:s14}}I found him lying on his back unconscious, and so extremely prostrated that he had but little control over the muscular system, and could not apparently make any motion, excepting a slight movement of the hands during a paroxysm of coughing. {{anchor:s15}}There was great emaciation; the face, body and limbs presenting the appearance of a child well advanced in marasmus. {{anchor:s16}}He had taken very little nourishment for several days.
{{anchor:s17}}The cough, which was worse during the night, was loose, rattling and recurred in frequent paroxysms, which were as violent as the strength of the patient would permit. {{anchor:s18}}Before the loss of consciousness, these paroxysms had apparently caused severe pain; and the patient now manifested some pain when coughing. {{anchor:s19}}The chest had, from the first, been very sensitive to pressure. {{anchor:s20}}The bronchial tubes were not cleared of the secretions by the cough, and appeared to be filling rapidly. {{anchor:s21}}Respiration hurried and rattling. {{anchor:s22}}Pulse 160. {{anchor:s23}}Bowels constipated; eyes fixed and insensible to light, and the cornea appeared to be shriveled. {{anchor:s24}}Skin clammy, and the extremities cold. {{anchor:s25}}Of course the case was apparently a hopeless one. {{anchor:s26}}I however prescribed one dose of Sulphur2000 at eleven o'clock, a.m., and awaited its effects. {{anchor:s27}}In thirty minutes slight relief was obtained, and at the end of an hour the improvement was very marked. {{anchor:s28}}I remained another hour, during which time the condition of my patient had so improved, that I considered it safe to leave him until the next day. {{anchor:s29}}I left the following prescription, one dose of Sulphur2000 to be administered if the child became worse. {{anchor:s30}}My directions were that it should not be given until it became evident that the aggravation of symptoms was permanent. {{anchor:s31}}Improvement continued until evening when consciousness was restored, after which there was further improvement up to midnight. {{anchor:s32}}From this time the patient remained about the same for an hour, and then gradually grew worse until four, a.m., when the second dose was given.
{{anchor:s33}}Marked improvement followed at once, and continued without interruption four days. {{anchor:s34}}I then gave another dose of Sulphur2000 which restored the child to perfect and continued health.
{{anchor:s35}}Case II. Phthisis Pulmonalis. {{anchor:s36}}— This occurred in a young man who had inherited consumption, was 23 years of age, had nervous sanguine temperament, light brown hair and light eyes.
{{anchor:s37}}He enlisted in the army and soon after went into active service in which he continued some months, when he was attacked with diarrhea and sent to the hospital. {{anchor:s38}}He was then very sick between two and three weeks, then recovered sufficiently to resume duty for one week, when he was again returned to the hospital; this time, with cough, chills, fever and night sweats, in addition to the diarrhea. {{anchor:s39}}These symptoms continued though varying in severity, through the succeeding four months, during all which time, of course, he continued under army or allopathic treatment. {{anchor:s40}}He was then transferred to a hospital in Philadelphia where he was discharged from the service on a certificate of his attendant army surgeon, which avers, "disability from phthisis pulmonalis.{{anchor:s41}}" A few days after his discharge, he called upon me at Buffalo for medical treatment. {{anchor:s42}}Upon examination I found his condition and symptoms as follows:
{{anchor:s43}}The superior lobe of the right lung contained tuberculous deposits throughout; and there were considerable deposits of tubercle in the apex of the left lung. {{anchor:s44}}The patient complained of much soreness in the right lung, which he referred to the central portion of the superior lobe. {{anchor:s45}}This soreness was aggravated more or less by his cough, which also at times excited darting pains through the superior part of the right side of the chest. {{anchor:s46}}The cough occurred in severe paroxysms in the morning on rising, and in the evening on going to bed, and was also quite troublesome during the day and sometimes annoying at night. {{anchor:s47}}Expectoration, which attended the cough at all times, was yellow or gray, often a mixture of the two, in the morning, and frothy with a partial mixture of yellow through the balance of the day. {{anchor:s48}}Chills, fever and night-sweats were, much of the time, present. {{anchor:s49}}The chill generally occurred at about ten, a.m. {{anchor:s50}}Diarrhea troublesome, but painless. {{anchor:s51}}Appetite poor. {{anchor:s52}}Pulse about 100 per minute. {{anchor:s53}}The patient had, of course, become considerably emaciated, and his strength was much exhausted. {{anchor:s54}}For these symptoms I prescribed Arsenicum2500, one dose, and awaited the result.
{{anchor:s55}}Two weeks from the administration of the above prescription, I received a letter from my patient saying his cough was very much better, chills, fever and night-sweats almost wholly controlled, diarrhea entirely relieved, appetite good, but was considerably annoyed with soreness, pain and bloating of the stomach. {{anchor:s56}}As the Arsenicum was evidently still acting, I saw nothing in these new symptoms which required, in the connection in which they occurred, further medication.
{{anchor:s57}}In the course of another week my patient called upon me. {{anchor:s58}}He said he was entirely relieved of his cough, chills, fever and night-sweats, and of the soreness in the right lung, and had gained some ten pounds in flesh. {{anchor:s59}}His appetite was good and he was gaining strength rapidly. {{anchor:s60}}The soreness, pain and bloating of the stomach were much better and bowels entirely regular.
{{anchor:s61}}Seeing no further occasion for my services, in my patient's case, I dismissed him without further medication, the single dose of Arsenicum being all I had administered in his case. {{anchor:s62}}Some weeks after this, my patient informed me that he found himself in the enjoyment of health, and that he had resumed work at his trade, which is that of a carpenter.
{{anchor:s63}}Case III. This case, which did not reach the character of a distinct, disease arose under the following circumstances:
{{anchor:s64}}I attended a lady in confinement, and, as labor was in every way natural, I considered further attendance unnecessary. {{anchor:s65}}Before leaving my patient, I informed her that she would not probably have an evacuation of the bowels in less than five or six days, and in case of this delay she need give herself no uneasiness; in any event she must take no suggested cathartic or other medicines.
{{anchor:s66}}I heard nothing further from the case until the fourth day after confinement when a messenger came for me in great haste, saying my patient was suffering from extreme pain. {{anchor:s67}}I found the lady sitting up in bed with her hands upon her abdomen and writhing as though in great agony from what she ascribed as griping pains. {{anchor:s68}}She had been in this condition nearly an hour; surprised at meeting with such symptoms and at the suddenness of their appearance, I enquired the cause and found that the patient had been visited that morning by some lady friends, who told her she would certainly have inflammation of the bowels if she did not get an action of them immediately, although, at the time, she was entirely free from pain, and in every way comfortable.
{{anchor:s69}}Under the alarm which these meddlers created in the mind of the patient, she took a table-spoonful of Castor Oil. Soon after taking this she began to have pain in the bowels, which increased in severity until I arrived about two hours after the dose was taken.
{{anchor:s70}}There had been no evacuation of the bowels. {{anchor:s71}}I promptly administered one dose of Nux vomica200 which gave entire relief in ten minutes, and the patient soon after fell asleep. {{anchor:s72}}I gave no more medicine, and my patient continued comfort- able four days longer when she had a perfectly natural evacuation of the bowels, the first since confinement, which was now eight days.
{{anchor:s73}}A noticeable feature of this case is that the Castor Oil never produced any action whatever, except causing the pain that was quieted by the Nux; since the cathartic action pertaining to the oil was never realized in the slightest degree.
{{anchor:s74}}CASE IV. Dysentery. — This was a case occurring in a hard laboring woman, of quite large bony frame, aged 44 years, of bilious nervous temperament, black hair and black eyes. {{anchor:s75}}She had been sick three days when I was called to her, and during this time had been taking laudanum, brandy, etc., but obtained no relief.
{{anchor:s76}}Symptoms. {{anchor:s77}}Frequent evacuations of the bowels accompanied by severe "bearing down" and. cutting pains in the hypogastric and sacral regions and soreness of the lower portion of the abdomen upon pressure. {{anchor:s78}}Stools were composed entirely of blood and inspissated mucus passed in small masses. {{anchor:s79}}There was tenesmus vesicae, urine high colored, causing burning pains when passing.
{{anchor:s80}}Appetite poor; considerable thirst and some tendency to nausea. {{anchor:s81}}There was a very thick coating on the tongue of a yellowish white color, which covered the central third in width, through the entire length of the organ, while the surface at either side was nearly natural in appearance.
{{anchor:s82}}There was some fever; pulse about 90 per minute, full and hard; some pain in the forehead; sleep much disturbed; aggravation of symptoms during the night.
{{anchor:s83}}Treatment. {{anchor:s84}}I administered Mercurius cor.1000 one dose, five pellets,%%*[%%In all cases where pellets are mentioned the No. 1 1/2 is to be understood, as I invariably use this size in all my practice.] and left my patient until the next day, when I found all her symptoms much relieved. {{anchor:s85}}I still allowed the one dose to continue its action another day when I found my patient sitting up and reading, and so far recovered that I dismissed her case. {{anchor:s86}}The dysenteric symptoms had all been controlled; the tongue was entirely clean, moist and natural; appetite good, and she was recovering strength rapidly.
{{anchor:s87}}Two days subsequently I was recalled to the case. {{anchor:s88}}My patient had brought on a relapse by exerting herself too much and eating too heartily. {{anchor:s89}}The symptoms in this relapse were severe, and as nearly like those of the first attack as it was possible for them to be. {{anchor:s90}}I again administered Merc. cor. 1000 one dose, five pellets. {{anchor:s91}}This controlled all the severe symptoms in a few hours, and a rapid recovery followed. {{anchor:s92}}I gave no more medicine, and at the end of one week the patient appeared to have regained all of her natural strength, and resumed labor without any return of symptoms or further inconvenience.
{{anchor:s93}}CASE V. Cholera Morbus. {{anchor:s94}}— This occurred in a man who possesses one of the most powerful physical constitutions that I ever met. {{anchor:s95}}He is six feet and one or two inches in height, has a very large and well developed chest. {{anchor:s96}}Ordinary weight 210 to 215 pounds, and is well proportioned. {{anchor:s97}}Temperament, nervous-sanguine-lymphatic; was 34 years of age; had been very healthy through life, with the exception of one or two attacks of fever, of short duration, in former years. {{anchor:s98}}I can assign no cause for this attack of cholera morbus, unless it is to be found in the fact that the patient was subjected to great irregularities of diet and sleep during two or three days traveling, immediately subsequent to several weeks very arduous attention to in-door business.
{{anchor:s99}}Symptoms. {{anchor:s100}}The patient was first attacked with diarrhea, which was unaccompanied by any severe symptoms for twenty-four hours, when cramping spasmodic pains in the epigastrium and umbilical regions ensued, which increased in severity, until at the end of twenty-four hours — when I was called they had assumed great violence. {{anchor:s101}}The paroxysms of pain occurred about once in ten minutes and were of such violence that the patient would be suddenly thrown into almost a convulsed state, with the thighs thrown up upon the abdomen, and the chin down upon the chest. {{anchor:s102}}These paroxysms were attended with severe retching and vomiting.
{{anchor:s103}}The matters ejected from the stomach were fluid, nearly colorless, exceedingly sour, and contained no solid matter, except that the first thrown off held some small portions of undigested food.
{{anchor:s104}}Evacuations from the bowels had taken place once in two or three hours, and were preceded and attended with considerable pain; but nothing so violent as that which accompanied the vomiting. {{anchor:s105}}During the interval of the violent paroxysms of pain, the patient was quite delirious and would sometimes fall into a very uneasy sleep-, which, was troubled with incoherent talk and muttering. {{anchor:s106}}Pulse 120 per minute; small and weak. {{anchor:s107}}Extremities becoming cold.
{{anchor:s108}}Treatment. {{anchor:s109}}I administered Nux v.2000 one dose, five pellets. {{anchor:s110}}This to all appearance caused an almost instantaneous aggravation of symptoms. {{anchor:s111}}The paroxysms of pain were more violent, and more frequent, coming now as often as once in three to five minutes; the vomiting was more profuse, and the delirium greater. {{anchor:s112}}The aggravation continued from twenty to thirty minutes, when the paroxysms lessened in violence, and their intervals lengthened, until at the end of three hours all violence or even severity of symptoms had so far yielded that there was left only an occasional mild griping pain in the stomach together with the soreness of the abdomen which such an attack would necessarily produce. {{anchor:s113}}I gave no more medicine; none from the first but the one dose.
{{anchor:s114}}The patient recovered rapidly during the succeeding two days, from the soreness of the bowels, and the weakness left by the attack, and on the third day resumed his business, prosecuting it with all his accustomed vigor, without a return of any of the symptoms; in short, had then fully recovered all his natural strength and energy of constitution.
{{anchor:s115}}CASE VI. Chronic Bronchitis. {{anchor:s116}}— This patient was a married man, aged 26 years, of nervous-sanguine temperament, fair complexion, light hair and blue eyes. {{anchor:s117}}He had evidently inherited a marked catarrhal, if not a consumptive taint; as other members of the family had been troubled considerably with catarrhal ailments, and one brother had suffered from asthma from his infancy.
{{anchor:s118}}The case under consideration had, for its immediate developing cause, a severe cold taken in the month of February, 1862, which immediately settled upon the lungs and promptly developed a very serious class of symptoms. {{anchor:s119}}The patient at once placed himself under the care of a homoeopathic physician, who continued his treatment, without intermission, until the succeeding August when, despairing of his patient's recovery, he sent the case to me.
{{anchor:s120}}Symptoms. {{anchor:s121}}The cough which succeeded the cold was severe from the first, and continued to increase in severity until I first saw the patient, when it was one of the most violent in character that I ever met. {{anchor:s122}}It occurred in both short and in long paroxysms, and was present at nearly all hours of the day and night, but most severe in the evening and before midnight. {{anchor:s123}}It generally began to increase in severity at four or five o'clock in the afternoon, though sometimes not until after tea, and would then continue severe through the evening until bed time, when upon lying down it would assume greater violence for an hour or more, then partially subside; though still remaining severe enough almost always to prevent sleep until midnight, and quite often to prevent it until three or four o'clock in the morning.
{{anchor:s124}}There were also severe paroxysms of coughing in the morning on rising, but as soon as the bronchial tubes had apparently been once cleared of the secretions poured into them during sleep the severity of these would give way, most of the time, though not always, to milder paroxysms during the day until the regular time for the increase of the cough in the evening. {{anchor:s125}}Expectoration attended the cough more or less at all times, and was sometimes accomplished without much effort, and at others with extreme difficulty. {{anchor:s126}}The sputa varied much in color and character, being transparent, frothy, yellow, green and bloody, at different times. {{anchor:s127}}In the morning on rising, it would be yellow or green, sometimes both, though much more commonly the former, and during the day frothy and transparent, with yellow matter occasionally present; while in the evening and night, during the violent paroxysms of coughing it was not uncommon for the sputa to be bloody or streaked with blood. {{anchor:s128}}It was also at times quite fetid.
{{anchor:s129}}Chills, fever and night sweats had been much of the time, from the first, daily occurrences in the case; though at times these were absent a few days and would return. {{anchor:s130}}The chills occurred at different times in the day, sometimes there being two — one in the morning at eight or nine o'clock and the other in the evening at about the same hours — but more of the time there was but one chill a day, and that occurred at about noon. {{anchor:s131}}The chill, when occurring but once a day, was generally severe, lasting about an hour, and when twice a day was of shorter duration and less severity. {{anchor:s132}}Fever always followed the chills, and at times would run high, especially after the more severe ones. {{anchor:s133}}Sweating at night Was often profuse, sometimes occurring many nights in succession, then suspend one or more nights and again resume. {{anchor:s134}}Pulse varied from 90 to 110 per minute.
{{anchor:s135}}The patient complained much of soreness and dull heavy pain in the mammary and clavicular regions of both lungs, but most in the left one. {{anchor:s136}}Considerable soreness and irritation existed, at times, in the throat. {{anchor:s137}}Occasionally severe paroxysms of dyspnea occurred. {{anchor:s138}}The appetite varied, though much of the time was very poor. {{anchor:s139}}Thirst at times annoying. {{anchor:s140}}There were no prominent symptoms of the stomach. {{anchor:s141}}Diarrhea was very troublesome full half the time, but was not attended with much pain.
{{anchor:s142}}The patient, was, of course, much emaciated and had lost strength so that he was only able to walk a short distance at a time. {{anchor:s143}}There was marked dullness of sound, on percussion, over the whole anterior surface of the chest, and auscultation revealed extensive irritation throughout both lungs. {{anchor:s144}}In fact there was hardly a spot over the whole chest where the morbid sounds which indicate more or less severe inflammatory action in the bronchial tubes could not be heard. {{anchor:s145}}In addition to this, there were unmistakable indications that the disease had advanced to the stage of tuberculous deposit, and I believe this matter to have been present in small masses throughout considerable portions of each lung; but I could detect no cavities, certainly no large ones, resulting from the suppuration of the tubercle. {{anchor:s146}}The left lung, in almost all respects, was the farthest advanced in diseased action.
{{anchor:s147}}Treatment. {{anchor:s148}}— No one familiar with our Materia Medica will fail to see in many of the symptoms, above narrated, a striking resemblance to the symptoms of Arsenicum, and this was the remedy apparently indicated. {{anchor:s149}}I say apparently, because there was no other remedy which covered the symptoms as they presented themselves, so well as this; and I had about concluded to prescribe it, when upon inquiry I found the patient had been informed by his physician — I had no direct report on the treatment of the case from the physician himself — what drug he had taken, and that Arsenicum had been a very prominent remedy in his treatment. {{anchor:s150}}Acon., Bryonia, Hepar sulph., Mercur., Spong., Sulph., etc., had been given, but neither of these had been so commonly used as Arsenicum, which had been the main reliance for some length of time previous to my seeing the case. {{anchor:s151}}All the above remedies, however, were given, as nearly as I could learn, in the low potencies, and alternated or repeated, as the case might be, at intervals of only a few hours. {{anchor:s152}}Here then was a new and important feature of the case which I could not overlook. {{anchor:s153}}Was Arsenic the drug indicated when it was first given, and had it aggravated the symptoms — it certainly had not acted as a curative — by being administered in too low a potency and at such short intervals; or had it masked, in part, the symptoms of the disease by producing those wholly its own, which for the time were as prominent as those of the disease? {{anchor:s154}}These were questions which I could not answer at the time, but was decidedly of the opinion that the symptoms of the disease were either aggravated or masked by the drug or drugs that had been administered. {{anchor:s155}}Under this conviction I set myself to the task of selecting the proper remedy for the case, as Arsenic must, of course, be discarded from further use. {{anchor:s156}}My task was one in which I met with but little success for a time, from the fact that the patient lived at a distance and only remained some twenty-four hours where I could see him, thus, of course, cutting me off from all advantage of seeing the case at brief intervals and comparing the symptoms one day with another, and in this way arriving at the remedy indicated. {{anchor:s157}}I prescribed, however, Drosera200, Calc. carb.3000, Belladonna300 and Nux vomica2000, each one dose, at intervals of a few days. {{anchor:s158}}The first and last two of these I gave more particularly to subdue, if possible, the violence of the cough, until I found the proper remedy, and thus avoid a rupture of blood vessels and hemorrhage which I feared might take place; while I gave Calc. carb. hoping from it some curative action. {{anchor:s159}}All this, however, resulted in failure in so far, at least, as relieving suffering or improving the condition of the patient. {{anchor:s160}}One result, however, was accomplished either by the delay, or possibly by the drugs which I administered. {{anchor:s161}}It was this, some of the existing symptoms passed through some changes, though they became none the less severe, while other and new symptoms, made their appearance, which, in the connection in which they occurred, pointed unmistakably to the remedy sought.
{{anchor:s162}}The most prominent new symptoms and changes of the old, were as follows: between two and three weeks after I first saw the patient, severe darting pains began to trouble him in the central and lower parts of the left lung. {{anchor:s163}}The soreness which had previously existed in both lungs, and been dull in character, had become more acute and was nearly all concentrated in the left one. {{anchor:s164}}The paroxysms of dyspnea became more severe and were attended with faintness, and all of these symptoms, together with the cough, were very much aggravated by lying on the left side. {{anchor:s165}}The sputa had also changed materially in one respect. {{anchor:s166}}What was described as "fresh blood" was now expectorated every morning. {{anchor:s167}}At the time the patient reported to me the above change in his symptoms, his family physician, who was still watching the progress of the case, wrote me as follows: "I examined his lungs yesterday and am of the opinion that a cavity actually exists, I likewise examined the expectoration with a microscope which revealed pus globules in considerable quantity, and he has had night sweats ever since coming home.{{anchor:s168}}" The patient further reported that he had lost strength, so that he was now obliged to lie down half of the time each day.
{{anchor:s169}}Now in putting all this together, and giving due prominence to the increased severity of the old symptoms in the left lung, together with the addition of the darting pains, and all aggravated by lying upon the left side, we have a case which no other known remedy covers so well as Phosphorus. {{anchor:s170}}I therefore administered one dose of this drug in the three thousandth potency, on the morning of the 4th of September, 1862.
{{anchor:s171}}It would no doubt interest the reader to peruse the daily record which the patient kept of his symptoms and forwarded to me, but as this was continued through a number of successive months, its insertion here would occupy too much valuable space, and I must therefore content myself with giving the more prominent results of the action of the remedy.
{{anchor:s172}}Only the day following the administration of the Phosphorus, the soreness of the lungs, which had been of such long duration and had recently become more severe in the left one, disappeared and, according to the patient's record, never returned except in a slight degree on one or two occasions after taking cold. {{anchor:s173}}The darting pains in the left lung were nearly as promptly relieved.
{{anchor:s174}}The cough, which had previously been so violent in character, was so much improved in one week that, at the end of this time, the patient reports it as "winding off.{{anchor:s175}}" Expectoration was now accomplished with ease, and the sputa changed so rapidly in character that at the end of two weeks he says, "I raise only a little mucus."
{{anchor:s176}}On the 20th of September, he further says, "I can swell out my chest without hurting my lungs, they are free from pain at present.{{anchor:s177}}" From this time on to the close of the treatment his report contains no complaint of pain in either lung, except on two or three occasions, and it was then of short duration and of much less severity. {{anchor:s178}}Chills, fever and sweats better, but not so rapid improvement in these as in other symptoms. {{anchor:s179}}His appetite, which had been unusually poor for two weeks before taking the dose of Phosphorus, rapidly improved and soon became so good that the record says, "I get hungry and have to eat between meals every day.{{anchor:s180}}" The diarrhea remained about the same. {{anchor:s181}}The patient's strength increased about in the ratio of the improvement of the symptoms in general; and the pulse was somewhat reduced in frequency.
{{anchor:s182}}As soon as the soreness and pain of the left lung were relieved, the patient began to complain of pain in the legs, and this increased until it became almost a regular daily symptom and was at times the cause of great suffering.
{{anchor:s183}}On the 11th of September he reports, at nine, a.m., "legs have ached hard all the morning, it hurts me now to walk.{{anchor:s184}}" The following day he says, "legs ache very hard, left one hardest.{{anchor:s185}}" During the succeeding five days there was quite rapid improvement in all the internal symptoms, but no particular change in the symptoms of the legs. {{anchor:s186}}These continued painful every day until the 16th of September, when the patient says, "had a severe attack of diarrhea last night; legs do not trouble me when the diarrhea is severe."
{{anchor:s187}}September 17th. {{anchor:s188}}"My knees commence to pain me, and are quite lame.
{{anchor:s189}}18th. {{anchor:s190}}"Legs ache hard; knees very sore."
{{anchor:s191}}19th. {{anchor:s192}}"Soreness of my sides below the ribs, and the whole lower part of my abdomen, and my legs are sore the whole length."
{{anchor:s193}}20th. {{anchor:s194}}Continued pain in limbs, and soreness of sides and abdomen.{{anchor:s195}}" It was on this day that the patient said he could "swell out his lungs," without experiencing pain.
{{anchor:s196}}22d. {{anchor:s197}}"Legs ache and are very hot below my knees, also my feet burn as if heated by fire."
{{anchor:s198}}23d. {{anchor:s199}}"Legs and feet continue to ache and burn, otherwise feel quite well; left foot lame."
{{anchor:s200}}24th. {{anchor:s201}}"Lungs a little stuffed: it is a damp day, left shoulder a little lame."
{{anchor:s202}}25th. {{anchor:s203}}"Legs ache harder than before; no soreness in either throat or lungs; back lame through the kidneys."
{{anchor:s204}}The succeeding ten days from this date the record is much the same. {{anchor:s205}}There was more or less pain in the left side below the ribs and in the back, and the pain of the legs was at time so severe that, the patient says, "it seems as though they would drop off."
{{anchor:s206}}Here it becomes necessary to state that I would allow the patient to make no external application whatever to the legs or other parts to relieve the pain, nor did I give any thing myself internally for this purpose, as I well knew that any such interference could do nothing but prevent a culmination of the disease in one or both legs — a result which I earnestly sought — and thus drive it back into the lungs, and hurry my patient to an untimely grave.
{{anchor:s207}}The following results show that it was well that nature's indication was not disturbed: On the 6th of October, the patient's report says, "a swelling or boil makes its appearance in my left foot at the ankle.{{anchor:s208}}" This went on favorably to suppuration and discharge, thus expelling from the system so much tuberculous matter at a far less vital point than the lungs, and where the irritation produced by the deposit and suppuration of the tubercle could work no danger to life.
{{anchor:s209}}That this was among the most favorable results which could have taken place, is shown by the fact that during all this time that the disease required to reach a culminating point in the legs, all the symptoms of the lungs, as well as the general symptoms improved. {{anchor:s210}}True there was yet left some cough, and this was more troublesome some days than others, but the patient almost constantly refers to it as "slight," and says, that expectoration is accomplished with ease. {{anchor:s211}}The chills, fever and night sweats much better. {{anchor:s212}}The appetite was good nearly all the time now, and the patient was gaining in strength daily.
{{anchor:s213}}This improvement in all the symptoms continued another week, when, thinking that the single dose of Phosphorus administered, September 4th — being now thirty-nine days since — must by this time have exhausted its action, and fearing that the disease might, through neglect on my part, gradually return to the lungs, I prescribed another dose of Phosphorus2000 which was taken on the morning of the 13th of October. {{anchor:s214}}In this I evidently committed a serious mistake; this dose having produced a severe aggravation, continuing through the succeeding two weeks. {{anchor:s215}}The cough increased and became severe, expectoration more difficult, sputa greater in quantity and changed from transparent mucus to thick and yellow matter; chills more severe, pulse increased in frequency, appetite became quite poor, in short all the symptoms which would arise from or be aggravated by increase of disease in the lungs were present in greater severity than at any time before, since the first dose of Phosphorus was taken. {{anchor:s216}}This aggravation continued until the 24th of October, when boils made their appearance again, but this time upon the shoulders. {{anchor:s217}}The report from which I have already quoted so frequently, says of them, "they are small but very sore.{{anchor:s218}}" After these had suppurated and discharged, a marked mitigation took place in all the lung symptoms. {{anchor:s219}}So marked indeed was this, that the last chill which the patient had was on November 1st, only eight days after the eruption of this crop of boils.
{{anchor:s220}}On the 11th of November his record says, "cough almost stopped. {{anchor:s221}}I continue to have boils yet.{{anchor:s222}}" All the other symptoms improved nearly as rapidly. {{anchor:s223}}Again during this improvement his legs pained him severely at times.
{{anchor:s224}}October 30th, he says, "left leg aches very hard and foot has swollen, it is inflamed and looks very red.{{anchor:s225}}" This time there were no boils upon either the leg or foot, as many had appeared and matured elsewhere. {{anchor:s226}}There was also a great deal of headache attending this second relief of the lungs.
{{anchor:s227}}For the succeeding two months there is nothing of particular interest to report, except that there was a steady and continued improvement of all internal symptoms, attended with an eruption of more or less boils upon the back, shoulders and neck until the last of December, when the lung symptoms increased considerably for a week or more, and I again prescribed Phosphorus3000, one dose, which was taken on the morning of January 2d, 1863. {{anchor:s228}}This gave immediate relief without aggravation and the case continued to improve until the 6th of February, when, in a letter — my patient was now so much better he had discontinued his daily record — he says, "I have had a bad cold, but am now over it; it did not effect my lungs at all. {{anchor:s229}}They feel as sound as ever. {{anchor:s230}}My pulse is regular.{{anchor:s231}}" Again on the 11th of February, he writes, "little pimples are coming out on my face and body, which arc quite sore and discharge a little.{{anchor:s232}}" Here, then, is disclosed, in this humour, the agent — call it psora or what yon will — that had been acting upon the mucous membrane of the bronchial tubes, and by its irritating presence there had caused the chronic inflammation and the tubercle, in short was the real primary cause — aroused from a dormant condition by the cold taken the previous February — of the long list of sufferings which the patient had endured through an entire year.
{{anchor:s233}}This eruption increased and was attended with further improvement in internal symptoms until about the middle of March, when there was a renewal of disturbance in the left lung, which, in a letter bearing date March 27th, 1863, he describes as follows: "I have been complaining a little harder for the past ten days. {{anchor:s234}}I first felt dull heavy pains in my left lung which kept growing worse until Monday the 23d. {{anchor:s235}}On raising up in the bed that morning, I was taken with a severe coughing spell. {{anchor:s236}}I felt something give loose in ray left lung, on raising it in my mouth I found there was a hard lump nearly as large as a pea, followed by matter of a bad taste and some fresh blood. {{anchor:s237}}My lungs pained me very hard at the time."
{{anchor:s238}}Of his examination of this mass, he says, "it was hard and of a dark yellow color. {{anchor:s239}}I opened it; on the inside was a black speck a little to one side of the centre, half as large as a pin's head. {{anchor:s240}}This black speck was hard, and when mashed by my knife, it broke like a piece of stone coal or cinder," He further says, "the next day after I raised this lump, my lung pained me some and I raised a little matter, and yesterday I had a most violent headache, lasting until midnight. {{anchor:s241}}Today my throat smarts some and I cough, but not hard. {{anchor:s242}}My lung has not felt sore today but little."
{{anchor:s243}}As the increase of symptoms in the left lung, at this time, was evidently owing to the process of detaching and expectorating the mass which the patient describes in the language above quoted, and as the lung was now rid of this disturbing agent, I concluded that the effects which it had produced must soon cease, therefore gave no medicine but awaited the progress of the case. {{anchor:s244}}I did not hear from my patient again until the 25th of April, when he reported as follows: "I am feeling quite well, I had mostly got over the pain in my side when I received your last letter; it has all passed away now and I feel better than I have before in one year. {{anchor:s245}}I feel strong, and am gaining flesh. {{anchor:s246}}I do not cough but very little, that is in the morning when I first get up. {{anchor:s247}}My throat appears to be better than it has before since you commenced treating me.{{anchor:s248}}" Here then it was clearly demonstrated by this report, that further medication was as yet unnecessary.
{{anchor:s249}}On the 27th of May he again writes, "I am feeling almost well, I have no trouble with my lungs at all, they are as free from pain and I breathe as freely as I ever did. {{anchor:s250}}I am strong and gain flesh every day. {{anchor:s251}}I could stand a good day's work. {{anchor:s252}}I cough a very little yet, but my throat is gaining so that it does not trouble me but very little. {{anchor:s253}}My appetite is good and I cannot Bee but my pulse is right, it stands about 70 all the time."
{{anchor:s254}}Three weeks later, on the 18th of June, 1863, my patient called upon me. {{anchor:s255}}I had not seen him since the previous August. {{anchor:s256}}He had improved so much in appearance that I did not at first recognize him. {{anchor:s257}}The pallor of the countenance which was so marked ten months before, had given place to the color of health, the emaciation had been succeeded by considerable plumpness of muscle, and instead of the languor and depression which was then so manifest in every action, there was now that buoyancy of spirit, and activity of both mind and body which restored health and a renewed hope of life can alone give. {{anchor:s258}}There was no cough, no pain, no diarrhea, in short no active symptoms of any kind. {{anchor:s259}}I examined the lungs again by auscultation and percussion and found no indications of any disease then acting in either one of them.
{{anchor:s260}}At this interview he informed me of an important series of symptoms which arose in the progress of his cure, and which he had not before reported to me. {{anchor:s261}}Sometime during the month of December preceding, he began to suffer from pain in the roots of a partially decayed tooth, one of the left inferior molars. {{anchor:s262}}The pain increased in severity until it was at times the cause of much suffering, and in a few weeks resulted in a swelling of the gum which suppurated and discharged freely. {{anchor:s263}}After this abscess broke, he said it discharged a teaspoonful daily for many weeks and then slowly and partially healed, though still continued discharging a little at the time of this visit. {{anchor:s264}}Here, then, in addition to what the numerous boils had accomplished in expelling tuberculous matter from the system we have a great quantity of the same carried off through the gum, and the lungs, by this means, still further relieved from the ravages of tubercle. {{anchor:s265}}This action in the tooth and gum was not interfered with in any way by the patient, as he acted upon the advice I gave him at first, that any new symptoms occurring under treatment, especially if they arose in parts not vital and remote from the lungs must be let entirely alone, for like the boils, any successful attempt in controlling them could result only in disaster, by forcing the disease back to the lungs, from which it could probably never be removed a second time. {{anchor:s266}}The result shows, of course, that there was full compensation for the suffering borne from the tooth, as well as from all other parts not essentially vital.
{{anchor:s267}}Finding the condition of my patient in every way so favorable that in my judgment a little more time was all that was necessary for restoration to permanent and continued health, I gave him no more medicine. {{anchor:s268}}I had given him none now since the morning of the 2d of January, and since I found the curative remedy in his case I had given him only the three doses; the first September 4th, 1862, the second, October 13th, 1862, and the third, January 2d, 1863.
{{anchor:s269}}I have heard from my patient several times since his last visit to me, and to the time of his last report he continued in health, and was engaged in labor upon the farm.
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====== DOCUMENT DESCRIPTOR ======
^ Source: | The American Homoeopathic Review Vol. 04 No. 02, No. 04, 1863, pages 79-83, pages 165-168, No. 04, 1864, pages 322-333 |
^ Description: | Clinical Contributions; Pneumonia; Phthisis Pulmonalis (tuberculosis) |
^ Author: | Gregg, R.R. |
^ Year: | 1863 |
^ Editing: | errors only; interlinks; formatting |
^ Attribution: | Legatum Homeopathicum |